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Chemotherapy of osteosarcoma.
Clinical Orthopaedics and Related Research
|September 1, 1975
Summary
Adjuvant chemotherapy after osteosarcoma surgery significantly improves outcomes. Treatments like adriamycin, methotrexate, and multi-drug combinations reduce pulmonary metastases and improve survival rates in patients.
Area of Science:
- Medical Oncology
- Surgical Oncology
- Pediatric Oncology
Background:
- Osteosarcoma treatment has historically faced pessimism.
- Recent chemotherapy advances offer new hope.
- Adjuvant chemotherapy following amputation is a key focus.
Purpose of the Study:
- To evaluate the efficacy of different adjuvant chemotherapy regimens in osteosarcoma patients.
- To compare outcomes with historical data from amputation alone.
Main Methods:
- Three distinct adjuvant chemotherapy protocols were analyzed.
- Regimens included adriamycin, high-dose methotrexate with citrovorum factor, and multi-drug combinations.
- Data were collected from multiple institutions, including Roswell Park Memorial Institute, Boston Children's Hospital, and M. D. Anderson Hospital.
Main Results:
- Adriamycin adjuvant chemotherapy showed approximately 75% of patients free of pulmonary metastases at 19 months, compared to 10-25% with amputation alone.
- High-dose methotrexate with citrovorum factor resulted in only 1 out of 12 patients developing pulmonary metastases.
- Multi-drug combinations reported a 55% survival rate (10 out of 18 patients).
Conclusions:
- Adjuvant chemotherapy demonstrates a significant positive impact on osteosarcoma treatment outcomes.
- Current chemotherapy regimens can effectively reduce metastasis and improve survival.
- Further controlled, long-term studies are needed to fully answer remaining questions.